Sunday, July 8, 2007

Insurance: A SiCKO system

OK, so I mentioned that I went to see SiCKO on Friday. And I did really enjoy it. If you've seen any other Michael Moore movies, you know that he clearly takes sides on issues. A lot of people see him as a bit of a liberal nut. But he has always said how grateful he is that he lives in a place where he can voice his opinion when he disagrees with the powers that be. I think his willingness to stand up and speak out is very American, and very patriotic. He is using his freedom of speech more than most people.

That being said, I think SiCKO is probably one of his least political pieces. Whether you are Democrat, Republican, Green Party, Independent or something else, I bet you have a horror story that has to do with health care, and more specifically, with an insurance company. This movie brings those horrors to light, and hopefully will motivate people to do something. To stop feeling so beaten by the system that we accept it, but rather rise up and demand change. To stop letting the money behind this system buy our government. To put more value on all human life than on a system that allows the rich to get richer while less rich people die from lack of care. (Jen mentions this in her post one plus two: sicko. I look forward to her writing more about it)

One thing that I don't think the movie addresses, and I would like to know more about, is medical research. Most advances in medicine, whether it be drugs or machines or new procedures, happens here in America. How can we keep funding the research but not the large CEO bank accounts?

But the thing that really got me thinking was INSURANCE. We have insurance so that we will be "covered" when we need it. Not just health insurance, which this movie focuses on, but home owners insurance and car insurance. Life insurance. We pay money into this insurance every year. If we are lucky, we rarely use it. But then something big comes along. An injury. A car accident. Cancer. A hurricane.

Living in Southeast Louisiana in the wake of Hurricane Katrina I have heard more horror stories of insurance than I could begin to count. A neighbor whose home was literally split in half by one large pine tree had a sign in from of his home that said "ALLSTATE: Am I in Good Hands???" I couldn't help but think of these stories when watching SiCKO, because it's obvious that the same principals applied. Most insurance companies did not want to help all these people that they had been taking money from for years. They quibbled over whether or not damage was done from winds or from floods (it was a HURRICANE! Wind and water come together. You can not separate the two. Unless of course the flood comes from the breaking down of levees, which were damaged by the hurricane, and so then even there you see that it's all interralated. And don't even get me started on that...) It would take months for an adjuster to come and look at a damaged home. And then the amount that they assessed the damage for would not even come close to covering the cost of repairs (even PreK, but as you can imagine, costs went through the roof - no pun intended - after the storm) Insurance companies waited and waited and waited to write checks as they fought with our government over whether or not homeowners could rebuild in that area or not. Meanwhile, people still had to pay their mortgage, as well as pay for wherever they were living instead of their home. Insurance companies would offer homeowners a buyout - insulting things like $20,000 for your home, but taking the money meant you could never come back and ask for more. People took this in desperation.

It became so obvious that the insurance companies were not interested in helping people through this tragedy. They were concerned about losing money. About not having such an incredibly large profit that year. They began refusing to write new policies in the area, and people wanting to move couldn't sell their homes because of it. They raised prices in order to keep their profits.

I do have to put in a disclaimer here: my insurance company, AAA, treated us very well after the storm We had very minor damage, but it was quickly and fairly assessed, a check was written in a timely fashion, and we were called with an offer of money to cover our evacuation expenses. Most people practically fall over when I tell them how well we were treated.

It seems to me that the idea behind insurance is that we all put our money in a pot, to be used in case of emergencies. We hope that we never have to use it. But when we do, the money from that pot should be taken out to help a person in need. And maybe they will get a lot more than they ever put in. Maybe they will get the money that I put in but never needed. I am fine with this idea. I like the idea of helping someone when they need it, and trusting that the help will be there when I need it.

But our insurance companies clearly do not work this way. The system is broken. And it needs to be fixed.

You can click on the SiCKO button in the sidebar to learn more about what you can do about the broken health care system in America.


slouching mom said...

I have GOT to see this film. Thank you for reminding me.

In 2005, I shattered my right leg. I broke both the tibia and the fibula. I needed surgery to implant an external fixator (think Frankenstein's bolts), which I used for three weeks. Then surgery to take it out and put in 11 screws and 2 plates. Rehab for six months, twice a week.

The repair of my leg cost $50,000. I paid perhaps $250 of that total, on copays for Vicodin and copays for x-rays and the ER.

When the system works, it works beautifully. But it so rarely, rarely works.

slouching mom said...

I meant Frankenstein's MONSTER's bolts.

thirtysomething said...

First I must say that I am glad to come across another Michael Moore fan. I can't wait to see the film.
Insurance is such a necessary evil, in many respects. THen sometimes, as SM mentioned, it can work beautifully. Lovely post. Very true and heartfelt.
Goes without saying that I am jealous that you know how to do a sidebar before I do. :)

painted maypole said...

thirtysomething - if you go to the sicko website it gives you the html to copy, go to "Add an element" in your setup, pick the html/java script option and paste the html in there. Save your changes. Bingo. You have a little button in your sidebar. my guess is all sorts of websites provide similar ways to create a link, this is just the first time I've every done it.

Lawyer Mama said...

I can't WAIT to see this movie! SM is right, when the system does work, it works well - I had more than $60,000 in pre-natal care for my oldest son and didn't pay more than $200 in co-pays. But I also worked for an insurance company before I went to law school, so I know how wrong things can go for people. Plus, there are all those without insurance at all.

It's so funny how different insurance companies reacted so disparately to Katrina. I'm originally from La. & have relatives all over the state. Some were treated fantastically, forwarded money for evacuation costs and car replacement. Assessment happened quickly and fairly. And for others, the nightmare still drags on.

Candygirlflies said...

And this is the comment from the Canadian... who is blessed with one of the most amazing health care systems in the world... (That said, however, when it comes right down to it, there are still glitches that need to be fixed, and probably always shall be...) I am so grateful for what I have up here in The Great White North, though, even if my taxes ARE sky-high. It's worth it!!

I wanted to tell you our insurance success story, since you were so well treated by AAA. Last March, my husband became suddenly and violently ill while we were on vacation with our three girlies in Florida. Not only were we absolutely beautifully cared for (and I mean ALL OF US, not just The Husband with Kidney Stones) at Celebration Health Care Centre, it was CAA travel insurance that saved us. 7 hours in emerg later (including a CAT scan that was performed and results reported within the space of a half hour), we owed well over $5000. Everything was covered by the insurance. Everything.

I was so thankful. Yes, sometimes the system DOES work!! But I understand that for every happy story, there are plenty of sad stories of people who cannot afford either insurance or very basic health care in the US...

Jeffrey Dach MD said...

What is the real solution, if Michael Moore’s government sponsored universal health care is not the answer?

The crux of the "SICKO" documentary is the disconnect between our expectations and the reality of health care. We are expecting compassionate care from another human being, and instead we get a faceless corporation. The person behind the desk or window is an agent of a health care corporation, which is not a human being, whose primary goal is to increase corporate profit.

This is America, and corporate profit is good, the profit motive forming the basis America’s greatness. The basic problem is that a corporation is not a human being. Therein lies the fallacy of replacing a corporation with a government agency, neither of which is a human being, when what we really want is a human being to deliver compassionate health care, and assist in serious health care decisions.

Review of "SICKO", by Jeffrey Dach MD

Jeffrey Dach MD

painted maypole said...

Dr Dach - I have to disagree with you that profit motives are what makes america great, and if profit motives are what runs our health care system, then where does that leave the poor and uninsured? Alone and dying, I guess. I don't think that's a reasonable answer.

Human beings run corporations, and humans run the government. We need to change the idea that profit is more important than people. And that goes for a lot more things than just insurance.

thailandchani said...

I also have to disagree with Dr Dach. The profit motive is only good when it comes to DVD players or cars, not human beings.

Any civilized nation should have its citizens' well-being as a priority.

As for insurance, as a former medical insurance biller, I can tell you that the primary objective of insurance companies (regardless of the type of insurance) is to deny claims. That is why I decided to stop billing, even though it would have allowed me to work at home. It's a disgusting and corrupt system.



nomotherearth said...

Would you believe I've never seen a Moore film. I've seen bits and pieces of Fast Food Nation (was that him?). I get too emotionally involved in films, so I generally keep my watching to the saccharine and uplifting flicks. It's a problem I'm working on..

painted maypole said...

nomo - Fast Food Nation was someone else. I've never seen that whole thing either.

niobe said...

After reading this post, I definitely want to see the movie.

And on the issue of the profit motive -- because in the US insurance is run by private companies it has to make a profit, preferably (from the company's point of view) a large profit. There are two ways for an insurance company to make a profit: (1) charge a lot for insurance and (2) don't make payouts to customers. Neither is a particularly good thing if your goal is to have a fair, cost-efficient system that provides healthcare to everyone who needs it.

The advantage of having the government as the insurer for everyone is that the government has no need to make a profit (in fact, it often runs a deficit) and has much less incentive to deny people's claims. Moreover, because the government doesn't have to pay for a whole bunch of people to think of new and creative ways to deny claims, the costs are much lower.

Heather said...

I think this film is going to fan my already huge fiery furry.

Very good point about the home insurance too. Amazing that they hesitated and continue to hestitate to help their customers who are real people really suffering. Awful.

Thanks for the review.